The California Pregnancy-Associated Mortality Review (CA-PAMR) is a project of the California Department of Public Health (CDPH), Maternal, Child and Adolescent Health (MCAH) Program in collaboration with the California Maternal Quality Care Collaborative (CMQCC) and the Public Health Institute (PHI). CA-PAMR serves to determine the causes of maternal mortality and to make recommendations concerning quality improvement opportunities in maternity care and public health strategies to prevent maternal deaths in California. CDPH/MCAH and the CA-PAMR project are fortunate to have the voluntary service of the CA-PAMR Committee, a statewide, multidisciplinary Committee comprised of leading clinical experts in maternal and perinatal health and public health.

Goal

CA-PAMR seeks to strengthen California’s surveillance of maternal mortality and to determine its causes on order to identify public health and clinical interventions to reduce maternal mortality and associated racial/ethnic disparities.

Maternal mortality is a considered a sentinel event and serves as a warming sign of increased maternal morbidity, both chronic, underlying maternal medical conditions, as well as acute pregnancy-related injury or illness.

Program Activities

CA-PAMR was established in 2006 and reviewed maternal deaths from 2002 to 2007, the years with the sharpest rise in maternal mortality.

CA-PAMR consists of four components:

Enhanced surveillance of pregnancy-associated deaths by MCAH through the linkage of birth certificates with maternal and fetal death certificates and hospital discharge data. CA-PAMR identifies women who died within one year of having a live birth or fetal death;

Collection and abstraction of medical records by the Public Health Institute for deaths that are likely or known to be pregnancy-related;

Case review by the multidisciplinaryCA-PAMR Committee to determine whether deaths are pregnancy-related, causation, factors that contributed to the deaths and recommendations for improvements in maternity care;